Executive Order 13948, signed on September 13, 2020, directed the Department of Health and Human Services to implement a most-favored-nation pricing model for Medicare Part B drugs. The executive order would have allowed Medicare to pay no more for selected drugs than the lowest price paid by patients in other developed nations, fundamentally reshaping how the federal government negotiates pharmaceutical costs. The mechanism relied on the secretary of HHS to establish regulations permitting Medicare to reference international drug prices as a pricing ceiling, ostensibly leveraging the government's substantial purchasing power as a negotiating tool.

The order directly affected patients and beneficiaries enrolled in Medicare Part B, which covers injectable and infused drugs administered in clinical settings. Seniors and disabled Americans relying on expensive biologic treatments for conditions like rheumatoid arthritis, certain cancers, and autoimmune diseases would have been the primary population impacted, potentially lowering their out-of-pocket costs. Pharmaceutical manufacturers would have faced compressed profit margins on drugs sold to Medicare, affecting their revenue models and potentially their investment in research and development pipelines.

Federal courts blocked implementation of the rule before it took effect, preventing the direct restructuring of Medicare drug payments that the order contemplated. This judicial intervention meant that the most visible mechanism of the executive order never reached beneficiaries, leaving the pharmaceutical pricing landscape largely unchanged from its pre-order state.

The action reflects a pattern within the Trump administration's healthcare approach of asserting executive authority over regulatory agencies and pharmaceutical markets. Yet this stands in contrast to simultaneous deregulatory moves in other healthcare domains, such as the FDA's authorization of fruit-flavored vapes and the administration's shifts away from birth control provision through Title X. Where drug pricing invoked government market power and price controls, other healthcare actions emphasized corporate flexibility and reduced regulatory constraints. This apparent contradiction suggests the administration's healthcare agenda prioritized certain cost-control messages while simultaneously pursuing deregulation that benefited industry in other sectors.